甲亢伴周期性麻痹患者^(131)I治愈前后血浆RAAS系统变化及临床意义

Changes and Clinical Significance of Plasma RAAS in Hyperthyroidism with Periodic Paralysis Patients Before and After with ^(131)I Treatment

目的探讨肾素-血管紧张素-醛固酮系统(RAAS系统)在甲亢合并周期性麻痹患者131I治愈前后变化的临床意义。方法选取2011年3月至2014年3月就诊核医学科确诊甲亢并用131I治愈的病例295例,其中合并周期性麻痹患者54例为A组,不合并周期性麻痹患者241例为B组,测定其血清钾K+,甲状腺功能,RAAS系统水平变化。分别比较A组、B组于131I治疗前、131I治愈后血清钾、血浆甲状腺激素水平及血浆RAAS水平变化。结果131I治疗前A组和B组之间血浆RAAS水平差异有统计学意义(P<0.01),131I治愈后A组和B组之间血浆RAAS水平变化差异没有统计学意义(P>0.05)。结论甲亢合并周期性麻痹患者血浆RAAS系统水平升高可能是引起患者低血钾的一个原因,监测甲亢患者血浆RAAS系统水平变化对其是否合并周期性麻痹的预测判断有积极临床意义。

Objective To investigate the changes of level of plasma RAAS system （ PRA, AⅡ, ALD ） in hyperthyroidism with periodic paralysis patients before and after with 131I treatment and its clinical significance. Methods 295 cases of hyperthyroidism patients in which 54 cases of patienti with periodic paralysis （ Group A） and 241 cases without periodic paralysis（ Group B）were involved in thislstudy, The serum potassium, plasma levels of thyroid hormones （ FT3, FT4, TSH ）, plasma RAAS system （ PRA, A 11 , ALD ） level were determined before and after 131I treatment. Results There was significantly different on the plasma levels of RAAS between group A and group B before the 131I treatment（P 〈0.01）. The changes of the plasma level of RAAS after 131I treatment between Group A and Group B had no statistical significance （ P 〉0. 05 ）. Conclusion The increased level of plasma RAAS system （ PRA, A Ⅱ , ALD ） in hyperthyroidism with periodic paralysis patients may be a cause of low blood potassium, and the monitoring of plasma RAAS system levels might have clinical significance in the prediction judgment of patients of hyperthyroidism with periodic paralysis.